Individual
NEETA F BHUSHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
136 S BOLINGBROOK DR, BOLINGBROOK, IL 60440-2852
(630) 739-5500
(630) 739-5505
Mailing address
5855 N SHERIDAN RD, UNIT 26A, CHICAGO, IL 60660-3818
(773) 562-7868
(630) 739-5500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027625
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019027625
LICENSE NUMBER
IL
Enumeration date
07/17/2008
Last updated
07/17/2008
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